BACKGROUND: High-quality, shift-to-shift handovers by residents are critical to ensuring to patient safety. The 2011 Accreditation Council for Graduate Medical Education duty hour requirements have increased the number of handovers occurring daily, necessitating new approaches to this challenge. Research suggests standardized approaches, electronic systems, and education programs can improve the handover process. METHODS: We conducted a 2-phase, observational study comparing an electronic handover system (experimental) in one clinical setting to a standard card-based system (control) at a second site. Outcome data included an objective assessment of the completeness and accuracy of handovers, and resident assessment of the handover systems. In phase 1, data were recorded at both sites and not shared with residents. In phase 2, data from the experimental system were used to provide standardized feedback to residents on the quality of their handovers. RESULTS: A total of 3184 individual patient sign-outs were evaluated during the 11-month period. Following introduction of a feedback intervention in the experimental arm, errors were present in only 5.2% of handovers, compared with 16.1% of controls (P < .001), and 67% of the 38 residents responding reported they perceived the experimental system as facilitating better patient care. CONCLUSION: Regular, real-time feedback through an electronic handover system can improve the accuracy and completeness of handovers in patient care.
BACKGROUND: High-quality, shift-to-shift handovers by residents are critical to ensuring to patient safety. The 2011 Accreditation Council for Graduate Medical Education duty hour requirements have increased the number of handovers occurring daily, necessitating new approaches to this challenge. Research suggests standardized approaches, electronic systems, and education programs can improve the handover process. METHODS: We conducted a 2-phase, observational study comparing an electronic handover system (experimental) in one clinical setting to a standard card-based system (control) at a second site. Outcome data included an objective assessment of the completeness and accuracy of handovers, and resident assessment of the handover systems. In phase 1, data were recorded at both sites and not shared with residents. In phase 2, data from the experimental system were used to provide standardized feedback to residents on the quality of their handovers. RESULTS: A total of 3184 individual patient sign-outs were evaluated during the 11-month period. Following introduction of a feedback intervention in the experimental arm, errors were present in only 5.2% of handovers, compared with 16.1% of controls (P < .001), and 67% of the 38 residents responding reported they perceived the experimental system as facilitating better patient care. CONCLUSION: Regular, real-time feedback through an electronic handover system can improve the accuracy and completeness of handovers in patient care.
Authors: Christopher Nabors; Stephen J Peterson; Wei-Nchih Lee; Arif Mumtaz; Tushar Shah; Sachin Sule; Andrew H Gutwein; Leanne Forman; Etta Eskridge; Eric Wold; Gary W Stallings; Kathleen Kelly Burak; Carol Karmen; Caren F Behar; Christine Carosella; Shick Yu; Kausik Kar; Melissa Gennarelli; Gail Bailey-Wallace; Randy Goldberg; Gary Guo; William H Frishman Journal: Am J Med Date: 2010-04 Impact factor: 4.965
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Authors: Eugene S Chu; Mark Reid; Tara Schulz; Marisha Burden; Diana Mancini; Amrut V Ambardekar; Angela Keniston; Richard K Albert Journal: Acad Med Date: 2009-03 Impact factor: 6.893
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Authors: Alicia I Arbaje; Nicole E Werner; Eileen M Kasda; Albert W Wu; Charles F S Locke; Hanan Aboumatar; Lori A Paine; Bruce Leff; Richard O Davis; Romsai Boonyasai Journal: J Patient Saf Date: 2020-03 Impact factor: 2.243